Kernberg, in International Encyclopedia of the Social & Behavioral Sciences, 2001 3 A Psychostructural Nosologyīorderline personality organization is characterized by lack of integration of the concept of self and significant others, that is, identity diffusion, a predominance of primitive defensive operations centering around splitting, and maintenance of reality testing. During the past decade, researchers have begun to tease out some key biological correlates of these personality traits. Each of these traits has been shown to run separately in families of patients with BPD, and when they coincide in a relative, that individual is likely to meet criteria for a diagnosis of BPD. Two distinct personality traits, impulsive aggression and affective instability, which appear to have strong biological correlates, co-occur in patients with BPD. This article focuses on the neurobiological aspects of BPD. It may help in identifying factors that predispose to BPD, in clarifying the relationship between BPD and so-called near-neighbor disorders such as bipolar disorder, and in guiding the development of pharmacologic treatments. Understanding the neurobiology of BPD provides a window onto one important determinant of the disorder. The patterns of feeling and behaving which characterize BPD are likely to arise from the interaction between biological tendencies and developmental life experiences. Washington, DC: American Psychiatric Association. Note: do not include suicidal or self-mutilating behavior covered in criterion 5.ĥ. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.Ħ. Affective instability due to marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).Ĩ. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, and recurrent physical fights).ĩ. Transient stress-related paranoid ideation or severe dissociative symptoms.įrom the American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Note: do not include suicidal or self-mutilating behavior covered in criterion 5.Ģ. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.ģ. Identity disturbance: markedly and persistently unstable self-image or sense of self.Ĥ. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, and binge eating). A pervasive pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:ġ. Frantic efforts to avoid real or imagined abandonment.
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